| NPI | 1740730357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation |
| Additional Taxonomies | 225XH1200X Occupational Therapist Hand |
| 225XN1300X Occupational Therapist Neurorehabilitation | |
| 225XP0200X Occupational Therapist Pediatrics | |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2020-06-25 |